Meet the team
Cons/Hon. Professor of Endocrinology & Metabolism
University Hospital of North Midlands
- England - West Midlands
Professor of Clinical Biochemistry
- England - West Midlands
- Julius Sim
- Karen Rodham
- Rick Fordham
- Martin Allen
- Seyi Ogunmekan
- Imran Hussain
- Julie Reeves
What is the challenge your project is going to address and how does it connect to your chosen theme?
1. Delay: patients with AI experience multiple delays from initial detection:
- Waiting for endocrine referral
- Waiting for referral for endocrine investigations and/or repeat imaging
- Waiting for results
- Waiting for repeat testing in borderline cases (>20% cases)
- Waiting for MDT slot
- Waiting for clinic appointment (first patient contact)
2. Patient exclusion: patients undergo repeated testing with no clear insight until seen in clinic
3. Patient anxiety: besides the initial shock of unexpected scan findings, the delay and ongoing exclusion accentuate and prolong their distress.
4. Unnecessary outpatient visits: Frequently, outpatient capacity is used for discussion of normal or borderline results, reducing efficiency.
By use of remote (telephone) consultation:
- Delay: Time to first contact significantly shortened
- Patient exclusion: Patients involved and informed from the outset
- Patient anxiety: Early engagement reduces distress
- Unnecessary outpatient visits: Avoided
What does your project aim to achieve?
- To engage and inform patients from the outset
- To reduce patient distress
- To reduce face-to-face outpatient visits
- To replace current face-to-face outpatient visits with a patient-focused telephone consultation service for new referrals and follow-up of borderline results.
- Time from referral to first interactive patient contact.
- Engagement/satisfaction levels (compared with current system).
- Patient anxiety scores (including modified Hospital Anxiety and Depression Score [HADS]).
- Number of face-to-face outpatient visits saved.
- Cost-effectiveness (using our AI2CAT tool developed during previous HF i4i project).
How will the project be delivered?
- Adrenal MDT team (including endocrinology, radiology, clinical biochemistry, urology): key clinical skills across the pathway from identification, management and investigations. Successfully secured funding for, and delivered, AI quality improvement projects (including two previous HF grants).
- AI Patients: Insight into impact of AI, questionnaire design. Already contributed to focus group discussion
- GP: Already part of the team, with insight on commissioning implications
- Qualitative researcher: questionnaire design, facilitation of focus groups and data analysis
- Statistician: qualitative data analysis
- Coding input
- Health economist: Already created AI2CAT cost-effectiveness tool
- Outpatient lead
Clear escalation strategy for abnormal/unexpected results, including emergency clinic slots.
- Keele University: statistics
- Staffordshire University: qualitative
- UEA: Health economics
- AHSN: adoption
- Q Community: Team includes 2 members
What and how is your project going to share learning throughout?
- Patient insight on telephone clinics as first interactive contact for new cases. Currently, telephone clinics are only utilised to reduce follow-up slots. Our approach will explore their potential for new patients. This will be evaluated using cost-effectiveness, coding, outpatient efficiency, impact on patient journey (delay), in addition to balancing measures (eg impact of service level agreements)
- Impact of intervention on reducing levels of distress and anxiety, whilst improving patient engagement/satisfaction.
- Q community/Q events: to learn (during the project) and share (after the project). We already utilise the Q Community RCT process to share ideas.
- West Midlands AHSN ‘Meridian’ platform (as used previously for our HF-funded AI project).
- Peer group sharing: National/international peer-reviewed publications/conferences.
- Patient Board: We will establish an adrenal patient group to facilitate peer support and partner in the service innovation/delivery process.
How you can contribute
- Assistance with refining existing patient engagement/satisfaction tools for our patient group.
- Any previous experience with use of telephone clinics for new patients.
- Insight/feedback on impact of telephone consultations on commissioning/contracts (balancing measures).
|26 Jun 2019|
|1 Feb 2020||Patient Board established & inital focus groups completed|
|31 Mar 2020||Patient Board update to refine tools|
|31 Mar 2020||Patient engagement/satisfaction & anxiety tools developed|
|1 Jun 2020||Data collection start|
|1 Jun 2020||Telephone clinic established|
|30 Sep 2020||Data collection completed|
|31 Dec 2020||Data analysis completed/dissemination plan created|